The use of musical elements to influence the learning of receptive communication skills in children with autism

Individuals with autism demonstrate impairments in the area of communication, with many lingering in the prelinguistic stage of communicative development. Early intervention implementing evidence based practices is recommended. Current research indicates interventions for individuals in this stage of development have focused primarily on facilitating expressive communicative skills, with little research investigating interventions to facilitate receptive communicative skills. In typically developing infants, the prosodic and repetitive characteristics of speech and song directed to infants are viewed as features of the prelinguistic language environment associated with communication development. While there is a correlation between attending to infant-directed speech and language outcomes in children with autism, these children are less responsive to infant-directed speech than their typically developing peers. Increasing the salience of infant-directed stimuli for individuals with autism may assist them to acquire receptive language. There is some evidence to indicate that individuals with autism may be responsive to music interventions, although little research in this area has investigated a relationship between music and communication. The focus of this study was to investigate if the auditory input evident in the prelinguistic environment could be enhanced through the use of musical elements to aid receptive language learning and engagement in children with autism and severe language delay. An experimental methodology with a cross-over design was used to compare the learning outcomes for children with autism and severe language delay in two intervention conditions: infant-directed song and infant-directed speech. The intervention was designed to teach children receptive labelling skills. Participants were recruited from Queensland State Special schools within a 50 km radius of the Brisbane CBD. Twenty two children (mean age 5.9 years) completed the research study. A computer-based intervention was developed employing evidence-based instructional practices appropriate for this group of children. The children were asked to identify pictures presented on a touch screen monitor during an interactive song/story. Four pictures were taught in each condition. Each stage consisted of four training sessions and fifteen individual teaching sessions and generalisation training. The order of the intervention was counterbalanced across participants. Data were collected on participants’ correct and incorrect responses. Video recordings were coded to provide data on participants’ level of engagement across the sessions. Generalisation and maintenance data were recorded. Data were statistically analysed using SPSS 19. Following the intervention there was a significant increase in learning the picture names in both the sung and spoken presentations, although no condition demonstrated superiority. Participants maintained learning at follow-up and generalised learning following both the sung and spoken condition. Children were more engaged during the sung presentation compared to the spoken presentation. Children’s level of engagement was positively correlated with receptive language learning. Wide variability was reported between participants. This study provided an initial investigation into the effect of the musical elements evident in the prelinguistic language environment on receptive language learning in children with autism, extending the theoretical knowledge base in this area. The findings from this research offer support for the use of the musical elements of melody and rhythm to be used within a multi-component intervention to create an engaging learning context to teach receptive labelling skills to children with autism and severe language delay. This study highlights the complexity of identifying evidence based practice and the need for researchers to analyse child characteristics and their relationship to learning outcomes. This knowledge will assist in developing learning contexts that will benefit children with autism.